Health& Wellness - Frank D. Lanterman Regional Center

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2 The New Medicare Prescription Drug Benefit: Its Effect on Regional Center Clients 4 You may have heard or read that the federal government has passed a law expanding the Medicare program to include a prescription drug benefit, called Medicare Part D. The new benefit will take effect on January 1, 2006 and it will affect Regional Center clients who receive health coverage under both the Medicare and Medi-Cal programs. These clients are called “dual-eligible.” The main change is that their prescription medications will be paid for by Medicare rather than Medi-Cal. There are several things that our dual-eligible clients, their families and service providers should know about the changes that are coming. LOW-INCOME SUBSIDY For people who are covered by Medicare only, there will be fairly substantial co-payments and other costs associated with this new drug benefit. People who are dual-eligible, however, will receive a low-income subsidy that will pay a large portion of these costs. In other words, Regional Center clients receiving Medi-Cal and Medicare will receive this low-income subsidy to help them pay the costs that Medicare-only beneficiaries must pay for prescription drugs. These clients will still be required to make co-payments, but the amounts of these co-payments will be small. For example, copayments for our clients will most likely be $1 or $3 for a prescription. In addition, this new benefit may not cover all of the medicines that a person is taking. (See below for more information) LETTER OF NOTIFICATION Anyone on Medicare can apply to receive the lowincome subsidy, but people who are dual-eligible don’t have to apply. The government has already decided that these people will receive the subsidy. So, during the month of June, Regional Center clients who are dual-eligible should have received letters from Medicare telling them that they will be getting the low-income subsidy. Clients and families should be sure to watch the mail for a letter from Medicare. If you receive such a letter of notification you do not have to reply to it. Regional Center clients should, however, notify their service coordinators that they received this letter. PICKING A PRESCRIPTION DRUG PLAN The Medicare prescription drug benefit will be provided through a series of “plans,” and each beneficiary must choose which plan they want to be covered by. These plans will differ from one another in the drugs that they cover. So, while one plan may cover all of the drugs a person takes, another plan might not. For this reason it is very important that a person try to find a plan that covers all of the drugs that they take. Clients and families should be assured, however, that the Regional Center will help ensure that clients have access to all of the medications they need. In the fall of 2005, all eligible beneficiaries will receive a letter inviting them to choose the prescription drug plan that they want to join. If a person does not choose a plan by December 31, 2005, the government will select one for them so that they can begin receiving the benefit on January 1, 2006. Clients and their families should be sure to make a choice so they will be enrolled in the plan that best meets their needs. At the moment we have no information about what prescription drug plans will be available to Regional Center dual-eligible clients or what will be covered by these plans. As we move closer to the fall, however, we will be receiving more information. We will then be able to help clients and their families evaluate the various plans to decide which one is the best choice for them. Parents of Children with Special Needs can Benefit from the New Paid Family Leave Law Article courtesy of the Paid Family Leave Collaborative (www.paidfamilyleave.org) Do you need to take time off work to care for your child with special needs? Are you worried about whether you can afford to take time off, or whether you will get your job back? California has a new law to benefit working parents who need to take time off to care for a child with a serious health condition. If you have a child with special needs, his or her condition may be considered a serious health condition, and you may be eligible for Paid Family Leave benefits. What are Paid Family Leave Benefits? Paid Family Leave benefits are partial wages paid by the Employment Development Department (EDD). Like short-term disability or pregnancy disability, the payments are approximately 55 percent of the employee’s wages. Employees can receive the benefits for up to six weeks each year, either intermittently or all at once, if they have to miss work to care for a child, spouse, registered domestic partner or parent with a serious health condition. Who is eligible to receive Paid Family Leave? Everyone who works and participates in the State Disability Insurance (SDI) program is eligible, whether they work full-time or part-time, and regardless of the size of the employer or how long they have worked there. Most California employees pay into SDI. (State, school district and some local government employees do not.) Check your paystub for an SDI deduction. To receive benefits, you must be taking time off work to bond with a new child (birth, adopted or foster) or to care for a parent, spouse, partner or child with a serious health condition. Does your child have a “serious health condition?” Under the new law, several common physical and mental impairments are considered serious health conditions. Some examples are asthma, epilepsy, cerebral palsy and spina bifida. Generally, a serious health condition is one which: • requires a hospital stay; or • prevents an individual from participating in normal activities for three days or more, for example, a child’s inability to attend school; or • requires multiple treatments to prevent incapacitating the individual; or • is a chronic serious health condition; or • is an incurable illness. Paid Leave Information Employment Development Department: 877.BE.THERE (English) 800.563.2441 (TTY) 866.658.8846 (Spanish) www.edd.ca.gov Legal Hotlines The Legal Aid Society – Employment Law Center: 800.880.8047 Asian Law Caucus: 415.896.1701 Equal Rights Advocates: 800.839.4372 California Women’s Law Center: 213.637.9900 To find out if your child’s condition meets the legal requirements, ask your health care practitioner or call the Paid Family Leave Collaborative numbers listed to the left. What if you need to take your child to appointments one day each week? Paid Family Leave benefits are available whether you take days off consecutively or intermittently. If you regularly miss work to take your child to appointments for therapy or treatments, you may receive benefits to compensate you for missed work time. Must the employer allow an employee to take leave? All employees covered by the Family and Medical Leave Act (FMLA) have the right to take leave and return to their job. You are covered by FMLA if you have worked for your employer for one year and 1,250 hours in that year, and your employer has 50 or more employees within a 75-mile radius. Even if you are not covered by FMLA, you may still receive Paid Family Leave benefits if you have been paying into the system. Talk to your employer about getting permission to take time off work. Parents with legal questions about their employment and Paid Family Leave should call the hotlines listed above. How to Apply for Paid Leave Benefits File a claim form with the Employment Development Department. Claim forms are available from your medical practitioner or from EDD. You will be asked to provide a medical certificate signed by a health practitioner stating that you are needed to care for the child. There is a sevenday waiting period before benefits are paid. This article is intended to provide accurate, general information about Paid Family Leave. Because laws and legal procedures are subject to frequent change and differing interpretations, the Paid Family Leave Collaborative cannot ensure that the information in this article is current, nor be responsible for any use to which it is put. Do not rely on this information without consulting an attorney or the appropriate agency about your rights. Online Resources for Airline Travel for Medical Needs: Association of Cancer Online Resources (ACOR) www.acor.org/ped-onc/resources/airlineflights.html The organizations listed on this site provide airline flights for patients that need to travel for medical reasons. Listings include a description of the type of air service offered and contact information. Some of the organizations included in this listing are Air Care Alliance, Air LifeLine, Angel Flight, Children’s Flight of Hope, Corporate Angel Network, Delta Air Sky Wish at United Way, Dreamline, LifeLine Pilots, Mercy Medical Airlift, Miracle Flights for Kids, National Patient Air Travel HELPLINE, Northwest Airlines Kid Cares program, Operation Liftoff, American Airlines Advantage Miles for Kids in Need, and Wings of Freedom.
The Director’s VIEWPOINT Rekindling the Spirit of Volunteerism The dictionary defines a volunteer as someone who undertakes a service of his or her own free will. Over the years, that willing and generous spirit has been an important part of regional centers. In fact, you could say that the regional center system itself was created by volunteers – committed parents and professionals who gave freely of their time and resources to craft a new way of serving people with developmental disabilities and their families. As we approach the 40th Executive Director Diane Anand anniversary of their efforts, I am struck again by the key role that volunteerism has played in our vision of fully included lives for persons with developmental disabilities. Individual contributions – whether of time, talent or financial resources – are the foundation of our future, as well as our past. In this new era of heightened demand and diminished funding, we must find ever more creative ways to engage our community. We have learned in the last few years that there are limits to government funding, and while is it crucial to have the safety net of the Lanterman Act entitlement, we can no longer – nor should we – rely on that alone. It is vital that regional center communities do as much as possible for themselves. We must rekindle the spirit of volunteerism. This issue of “Viewpoint” features several stories describing the impact of volunteers. One of them is Linda Landry. Nearly everyone who is affiliated with early intervention knows about her. I first met Linda on a visit to a legislator’s office to discuss the importance of early intervention services. She arrived with her infant daughter, and that began an association that has continued for more than 20 years. In that time, Linda has been tireless in her efforts on behalf of families with children who have disabilities and other special needs. The article lists her impressive accomplishments and awards. But even more important, I have seen her commitment to volunteerism not only help other people, but also transform her into a strong and resourceful citizen leader who continues to make a difference in the lives of parents and children with developmental disabilities. “As we approach the 40 th anniversary of their efforts [regional center founders], I am struck again by the key role that volunteerism has played in our vision of fully included lives for persons with developmental disabilities.” – Diane Anand Then there is Elliot Portnoy who, while a Rhodes scholar at Oxford University, established an innovative program that provided athletic opportunities for children and young adults with significant disabilities. It became KEEN – Kids Enjoy Exercise Now – a program totally run by volunteers and financial contributions. Mr. Portnoy is now a partner in the law firm of Sonnenschein Nath & Rosenthal LLP, in Washington, D.C. but continues his volunteer activities on behalf of KEEN. I recently participated in a town hall meeting to plan for the launch of KEEN programs in Los Angeles later this year. Of course, recruiting volunteers was first on the agenda. Finally, Lanterman Regional Center participated in the Achievable Foundation’s Reach for the Stars Fourth Annual 5K Walk, Run, Wheel and Woof in Century City. Staff, clients, families, service providers, and Lanterman friends and pets all banded together to make the event a huge success, proving that volunteers come in all sizes and ages. One hundred percent of the $25,192 in donations that Team Lanterman collected was returned to the Center to fund Camperships, the Roberta Happe Memorial Internship and various Koch ◆Young Resource Center projects. The importance of volunteers cannot be underestimated. Individual contributions of whatever kind are critical to the continued vitality of the Regional Center community. From a mother turning her own challenges into an opportunity to help others, to a successful attorney who can have national impact, to families and pets walking to raise money for those less fortunate, the rewards of volunteerism enhance our community and strengthen our self-reliance. I want to offer my personal thanks to the legions of volunteers who have given so unselfishly of their time, energy and financial resources, and extend my invitation to each member of our community to find the place where he or she can offer service. Each of us can make a difference – and together there is nothing we cannot accomplish. For more information about volunteer opportunities available with Lanterman visit www.lanterman.org and click on “Volunteer” at the top right of the screen, or call 800.546.3676. THE BUDGET UPDATE: We’ve Got a Budget! As this “Viewpoint” went to press we got word that the Governor and Legislature had agreed on a budget for 2005-06. These are some of the major provisions directly affecting regional centers: • The State will continue the freeze on rate increases for service providers. This means we will continue to have difficulty not only attracting new service providers, but also keeping existing providers who may not be able to afford to meet service standards. For example, residential service providers have not had a rate increase since the late 1980s. • There will be no startup funds for developing new programs, except those necessary to serve people moving out of state developmental centers. • Regional centers will receive additional operations funds to meet the federal requirements associated with the Medicaid Waiver program, although the amount is approximately one-quarter of what centers estimate is needed. This additional money, approximately $300,000 for Lanterman, will partially offset the half-million dollars that was taken from our Operations budget last year. • We will continue to operate with prior years unallocated reductions to Purchase of Services and Operations funding. Two additional changes will not directly affect regional centers, but will have a significant impact on our clients: • Beginning January 1, 2006, there will be an $1,800 dollar annual cap on dental Medi-Cal expenditures. • The State will suspend the state cost of living adjustment for people receiving the state supplement (SSP) to their SSI benefit. The suspension will be for two years, beginning in January 2006. Additional changes will result in delaying the federal cost of living adjustments for SSI recipients for three months in both 2006 and 2007. During each of these years, the adjustment will take effect April 1 rather than January 1. The good news is that the Governor withdrew his proposal to roll back the wages of In-Home Supportive Services (IHSS) workers to minimum wage. There is an additional major change proposed that will affect some regional center clients. This is the implementation of a new program referred to as Self-Directed Services. We will provide information on this program in a future issue of “Viewpoint.” The implementation of this program is contingent upon the approval of the federal government. Disability Resources Expo to be Held at L.A. County Fair on September 15 Do you want to learn more about physical and developmental disabilities, and the various services, resources and supports available? Then the “Abilities Resource Expo” being held at the L.A. County Fair at the Fairplex in Pomona on Thursday, September 15, 2005 from 11 a.m. to 10 p.m. is your one-stop source for a variety of disability-specific information. Representatives from California’s regional centers, Early Start and other infant and young children programs, programs for school-age children, vocational/employment programs, adult programs, and family support organizations will be on hand to answer questions and raise awareness about disabilities, provide information and connect people with disabilities and their families with services, resources and supports that promote choice, empowerment, independence and full integration into community life for people with disabilities. The “Abilities Resource Expo” is the only way to become educated about disability issues and resources, and eat cotton candy, learn how to milk a cow and hear great music all in one day. For more information about the “Abilities Resource Expo” visit www.sgprc.org. For more information about the L.A. County Fair visit www.fairplex.com/2005/homepage.asp. 3
Page 1: INSIDE: DIRECTOR’S VIEWPOINT page
Page 5 and 6: Lanterman Receives 2005 Public Serv
Page 7 and 8: Give Kids a Smile SM is a Shining S
Page 9 and 10: Walking for a Good Cause: Lanterman
Page 11 and 12: Precise Care Pasadena Empowers Clie
Page 13 and 14: Summertime Safety Continued from pa
Page 15 and 16: Save the Date! Through the Roof Sum
Page 17 and 18: “little man” Continued from pag

Health& Wellness - Frank D. Lanterman Regional Center

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